JACOB S LANE

CHARLESTON, SC
NPI1558999383
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207RN0300X Internal Medicine, Nephrology
(Licence: SC  89713)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2020-03-28
Last Update Date2023-05-31
Business Address
JACOB S LANE DO
169 ASHLEY AVE RM 202
CHARLESTON, SC 29425-7538
Phone number: 843-792-3298
Mailing Address
JACOB S LANE DO
169 ASHLEY AVE RM 202
CHARLESTON, SC 29425-7538
Phone number: 843-792-3298